Global Lung Cancer Awareness Month | Prevention and treatment of lung cancer

With the popularization of CT examinations in recent years, pulmonary nodules have become a popular Internet celebrity term among the public. Statements such as “ground-glass nodules” and “multiple micro-nodules can be seen” have made many people start to worry, fearing that if a pulmonary nodule is detected, it will develop into lung cancer.

Actually, the vast majority of pulmonary nodules are benign, and only a small portion of pulmonary nodules are eventually Diagnosed with early stage lung cancer. Even among people with a high risk of lung cancer, only a small number of small pulmonary nodules are diagnosed with lung cancer. Therefore, lung nodules are not equal to lung cancer, don’t talk about it, but you can’t let it go.

What exactly is a lung nodule?

Pulmonary nodules are not a disease name, but an imaging diagnosis, which refers to focal Sexual, round shape, abnormal lung shadow with increased density, which can be single or multiple, with a diameter of no more than 3 cm.

Some things about pulmonary nodules:

Among them, those with a diameter of less than 5 mm are called tiny nodules; those with a diameter of 5 to 10 mm are called small nodules; if the lung Nodules larger than 10 mm in diameter should be diagnosed and treated as soon as possible.

Generally, small pulmonary nodules do not cause any symptoms. The reason is that there are no pain-sensing nerves in the lungs, and pulmonary nodules are very small and do not cause pain or breathing problems.

“Ground glass nodules” are Lung cancer?

Pulmonary nodules appear as “small white spots” on CT, according to their density Divided intosolid pulmonary nodules (solid lesions only), pure ground glass nodules (without solid lesions) and mixed nodules (both ground glass and solid lesions).

In other words:

The distinction between a “solid” lesion and a “ground glass” lesion is largely dependent on whether the shadow is dense enough to hide the course of the . The shadows of ground-glass lesions are relatively blurred, and the contours of blood vessels and bronchus can be seen; the density of solid lesions is relatively uniform, and shadows of blood vessels and bronchus cannot be seen.

Among the above three types of pulmonary nodules, the highest probability of malignancy is mixed nodules, followed by pure grinding Glass nodules, solid nodules have the lowest probability of malignancy. Clinicians will comprehensively assess the risk of lung cancer according to the size of pulmonary nodules and whether there are malignant CT findings, and further distinguish them into high-risk, intermediate-risk and low-risk nodules, and give corresponding treatment strategies.

What should I do if I find that I have lung nodules ?

Screening finds lung nodules, first needRegularly reviewlung CT for follow-up observation; secondly, keep the chest radiographs or CT films of previous visits and provide them to the doctor when they visit again, so that it is convenient for the doctor to “dynamic “Observing whether there are changes in pulmonary nodules is very helpful for diagnosis.

Lung nodules change very slowly, there is no need for re-examination in a short period of time, the interval is several months, half a year or one year Re-examination is enough, and the doctor will recommend a corresponding re-examination interval according to the specific situation.

Most non-malignant pulmonary nodules will not grow up, if re-examination lung CT finds If the nodules do not grow or the density does not change, you can continue to observe; if the pulmonary nodules still do not grow after 2 years of observation, the possibility of lung cancer is extremely low.

If the re-examination of the lung CT finds that the nodules grow, it is necessary to determine whether it is lung cancer. This situation requires further examination, such as PET-CT, biopsy and so on. Pulmonary nodules with a diameter of more than 1 cm can be preliminarily judged as benign or malignant by PET-CT, and those with a diameter of less than 1 cm are usually difficult to show on PET-CT.

Most lung cancers grow relatively slowly, usually taking months to grow. Therefore, even if the pulmonary nodules are finally diagnosed with lung cancer, the lesions at this time are very likely to be small, and radical cure may be achieved through surgery and other methods.

Pass Is it safe to do regular CT review of pulmonary nodules?

At present, it is believed that patients with pulmonary nodules do not need treatment, and the practice of regular review of lung CT span>very safe and will not have a significant impact on subsequent treatment or cure rates. In fact, most patients with pulmonary nodules do not require biopsy or surgery. Biopsy is an invasive test, usually nodules larger than 8 mm in diameter may require biopsy.

Many people are worried about CT radiation. In fact, they follow the doctor’s advice to regularly review the lung CT radiation. Chest CT examination will increase the risk of radiation exposure. Therefore, it is not advisable to go to multiple hospitals for repeated lung CT examinations after abnormalities are found in the screening.

Pulmonary nodule How does the patient spend the follow-up observation period?

When screening finds lung nodules, “follow-up observation” is the most frequently mentioned by doctors of a word. If the pulmonary nodules detected by screening are small (eg, less than 4 mm) or considered benign, follow-up observation may be the best option.

Follow-up observation will not produce side effects, and will not cause drug resistance risk to later drug treatment; Visiting a doctor or being hospitalized not only saves medical expenses but also saves time and cost. Although follow-up observation has many advantages, it also has the risk of developing or spreading precancerous lesions or early cancers.

What needs to be explained is:

Follow-up observation will not make the originally benign nodules develop into malignant. Because,nature of pulmonary nodules does not change, benign nodules are always benign and malignant nodules are malignant from the start.

Follow-up observation does not mean letting go. During this period, patients will visit the doctor regularly for imaging or other related examinations. Changes will be given to patients in a timely manner to intervene accordingly. During the follow-up observation, some patients will feel anxious, worried that the pulmonary nodules will continue to grow, eager to know whether the pulmonary nodules are benign or malignant, and even worry that “doing nothing” will turn the benign nodules into malignant ……

So, how should patients with pulmonary nodules found in screening spend this special time better?

Reading more relevant popular science articles will help establish a more appropriate disease concept.

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During each follow-up visit, Tell the doctor about your doubts truthfully, and get professional and correct answers from the doctor.

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Don’t pay too much attention to lung nodules, but talk more with Communicate with family and friends and keep a positive, optimistic and open mind.

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4

During the follow-up observation period, maintain the previous normal living habits, pay attention to diet and Exercise, don’t treat yourself as a patient.

Related departments:

MDT joint outpatient clinic for small pulmonary nodules (joint clinic with specialists in respiratory medicine, thoracic surgery, and imaging)< /span>

Pulmonary small nodule MDT combined outpatient Departments of surgery, oncology, and imaging conduct joint consultations to formulate appropriate, individualized, and continuous treatment plans for patients with pulmonary nodules. Set up rapid inspection, green channel for treatment, and follow-up management services for case managers to improve the quality of patient consultation.

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